Monday, 28 September 2015 14:08

Breaking Down Breast Cancer

Did you know, according to the American Cancer Society breast cancer is the most common type of cancer in American women. However, modern medicine and technology are helping women live longer by discovering and treating breast cancer earlier. Stay informed and up to date with these breast cancer facts and tips.

What are the risk factors?

  • Age – Over 75 percent of women diagnosed with breast cancer are over the age of 50.
  • Genetics – Having a family history of breast cancer in a mother or sister can increase your risk for developing the disease.
  • Children – Having children later in life or choosing to have them not at all can increase risk.
  • Unhealthy Lifestyle – Lack of physical exercise, poor diet, being overweight and regular consumption of alcohol have also been shown to increase risk of breast cancer.

What about screening and diagnosis?

The most common screening test for breast cancer is a mammogram along with a clinical breast exam beginning at age 40. Women with a higher risk may also be advised to receive an MRI.
The warning signs for breast cancer differ for each woman. Some of the most common symptoms include:

  • A change in the look or feel of the breast and nipple.
  • A lump. Most lumps turn out to be benign and not cancerous, but it is still important to be cautious.
  • Swelling in the armpit.

Photo-1How do I treat breast cancer?

Breast cancer is often treated with surgery. Breast conserving surgery focuses on only removing the cancerous tissue from the breast, while a mastectomy is the surgical removal of the breast. Following surgery, patients often receive radiation therapy, which uses X-rays to destroy cancer cells. Some patients also require chemotherapy and/or hormone blocking therapy.

 

Sandra l. Gregory, MD

Board Certification: Radiation Oncology
Medical Degree: Robert Wood Johnson Medical School at the University of Medicine and Dentistry in New Jersey
Residency Training: Montefiore Medical Center and Weiler Hospital in New York
Undergraduate: University of New Hampshire
Special Interests: Breast Cancer, Head and Neck Cancer

Dr. Gregory is a member of the American Society for Therapeutic Radiology and Oncology. She has worked in hospitals and cancer treatment centers in Nebraska, Missouri, Arkansas, Tennessee and Georgia. Dr. Gregory has published articles in peer-reviewed journals and has presented her research findings at several national conferences.

Dr. Gregory resides in Alpharetta, Georgia. She is an avid and talented horseback rider.

Sponsored by: Atlanta Oncology Associates | (770) 255-7500 | www.atlantaoncology.com
Alpharetta | Atlanta | Eastpoint | Greensboro | Hawkinsville | Macon | Over 15 Hospitals and Centers

Thursday, 24 September 2015 14:07

My Best Self: Tracy Nicole

By Beth Carter

With more than a decade of experience in the fashion industry, Atlanta designer Tracy Nicole has achieved national recognition and built a celebrity-studded client roster through her Tracy Nicole Clothing line. Just a few years ago, Tracy had achieved success in her work and as a mom to two girls, but everything changed when she was diagnosed with breast cancer in her 30s. Tracy's in remission now, but she learned some valuable lessons during a tough season of her life.

Where did your passion for fashion begin?
It started really, really early with my grandmother. Every closet in her house was full of shoes and clothes. I taught myself to sew in high school, and I could cut out some fabric, sew it up into an outfit and wear it that night. But I grew up in a household where being creative was not supported; you became a doctor or lawyer. So I studied Occupational Therapy at Florida A&M University. After school, I started working seven days a week and became a workaholic. I made a lot of money but wasn't fulfilled. So I applied to fashion school and took classes at night. I realized how much I loved fashion because I'd work a full 12-hour day and then go to fashion school and feel like the day had just started.

How did you transition to a full-time fashion career?
In my Fashion Merchandising class, I created a business plan and eventually used the plan to open my Tracy Nicole store in Smyrna. I carried at least 50 different designers. After five years I was ready to do my own thing, so I closed the store and opened a design studio. Then two years into opening the studio, I was diagnosed with breast cancer.

How was the cancer discovered?
My mother is a three-time breast cancer survivor, so I had been heavily involved with breast cancer awareness. I even donated profits from my store opening to Susan G. Komen. My sister and I would talk about going to get mammograms, and we finally made an appointment. My sister's tests were negative, and mine weren't. That was a blow – totally unexpected – and I didn't know what to do. I was thankful I went to get tested, but it wasn't supposed to be like this. I decided to have an elective bilateral mastectomy.

How did you deal with your diagnosis?
I started to look for other young people's stories that had breast cancer, but the ones I found were heart-wrenching, and that's not what I wanted to read right then. I decided to start a blog called "Beneath the Petals," and it tells my story from day one. It has allowed me to open up, heal and deal with those feelings. I had over 15,000 views of my blog, and I ended up healing other people with it.

How did cancer treatment affect you?
I had doctor's appointments once a week, and that was my only outing, so I would dress up. When you go through a surgery like mine, there are a lot of tubes and bandages, and it was difficult to find something to wear. That's where the occupational therapist in me met the fashion designer, and I designed clothes to work around that. That would take my mind off of everything, and the focus would be on the clothes.

Where do you draw inspiration for your clothes?
Traveling and people watching inspire me. I think of wanting to look good and feel good but still be comfortable in the clothes. I enjoy taking trips outside of the country. Anytime I need inspiration, I just go somewhere new!

What habits help you be your best self?
I am a big stickler for eating healthy and exercising. When you're taking care of your body and exercising, you feel healthier, and I feel like that makes you healthier.

 

Thursday, 24 September 2015 13:55

Meet TurningPoint Founder Jill Binkley

By Amy Meadows

When Jill Binkley received her second breast cancer diagnosis in 2007, she knew what to expect. The busy mother of three underwent the same treatment that she had seven years earlier at the age of 40: a mastectomy followed by chemotherapy and radiation. But there were some differences the second time around. For instance, the cancer was located in her left breast instead of the right one, and it surprisingly was not a recurrence of the first cancer – a rather uncommon circumstance. What's more, during her second bout with primary cancer, Binkley was not as scared. And for good reason.

"By that time, I could turn to the people at TurningPoint," says Binkley, executive director of TurningPoint Breast Cancer Rehabilitation, which she founded in 2003. "I had created my own support."

Photo-001Starting a nonprofit organization that provides rehabilitation services directly related to breast cancer treatment was never something Binkley planned to do. However, her own experience opened her eyes to the need for the important services that TurningPoint now offers. "When I was first diagnosed in 2000, I was really shocked at many of the side effects of the breast cancer treatment, both emotional and physical," explains Binkley, a trained physical therapist who specialized in orthopedics and sports injuries. "When you have a mastectomy, there is significant pain after the surgery. You can have difficulty moving your shoulder and arm. You have weakness and fatigue from the chemo. It can really impact your quality of life. And I developed lymphedema, a swelling of the arm that's not an uncommon side effect. But I wasn't aware of what it was." Astoundingly, at the time, her medical team didn't really have any resources to recommend to her as she navigated the ramifications of treatment.

"If you think about it, when you have major surgery on your knee, you're referred to physical therapy or rehab," Binkley observes. Yet, 15 years ago, no one extended those services to women who were diagnosed with breast cancer. And as Binkley researched her own issues and tried to find solutions during her first two-year recovery, she quickly realized that she was not alone. So, in 2003, she opened the doors to TurningPoint Breast Cancer Rehabilitation. Initially, she began with her own area of expertise: physical therapy that includes gentle, hands-on stretching, manual therapy and exercise for muscles that are stiff, painful and have lost range of motion after a mastectomy or lumpectomy. Then, over time, she and her team of professionals added services based on patients' needs. "We would hear from patients about what they needed and what they weren't receiving," she says. Today, TurningPoint offers an array of clinical services, including specialized physical therapy and lymphedema management, massage therapy, counseling, nutrition guidance, an exercise program and a special program for women with metastatic breast cancer (Stage 4 breast cancer that has spread to other parts of the body).

SB-01"Everyone on our staff specializes in breast cancer rehab. We know about the stages of breast cancer and its treatment and all of the physical and emotional effects," Binkley notes. That's because every person on staff has been touched by breast cancer in some way. She continues, "Each of us has either gone through it ourselves or has had someone close to us go through it. We have a lot of compassion for our patients because we truly understand their journey."

That empathy is one of the most important components for the nearly 3,000 patients who have become part of the TurningPoint family over the last 12 years. "It can be difficult to talk to close family and friends. When you do talk about your fear and your concerns, you feel like you're complaining," Binkley explains. "Our patients feel like they need to be strong. And when they come in, many times this is the first time they've admitted that they're having a rough time. We offer them a safe place to talk about these things." Binkley points to one patient who summed it up perfectly. A wife, mother and full-time professional, the patient felt like she had to do it all without putting strain on anyone in her life. Binkley recalls, "She said, 'Out there, I have to be Superwoman. But when I come here, I'm allowed to leave my cape at the door.'"

That's exactly the type of support Binkley wants to provide to women with breast cancer, regardless of their financial situation. That desire led her to start TurningPoint as a nonprofit, which was an excellent decision. In addition to removing the financial barrier for patients who normally would not be able to afford such comprehensive services, the organization has the ability to implement new services and programs quickly when funding is available. "There is a push nationally to get these services into hospitals and other clinics, but being a community-based clinic, we're light on our feet. It's easier for us to respond quickly and provide patients with the services they truly need," Binkley explains.

Fortunately, community support for TurningPoint has grown steadily over the years. In addition to grants from organizations like the Susan G. Komen Breast Cancer Foundation and the Atlanta 2-Day Walk for Breast Cancer, TurningPoint receives much of its funding from local donors – many of whom are former patients. "It's amazing that you can affect someone so much that they're willing to come back and support you like this. As a physical therapist, I was so surprised by that. It's a very different model of care from the traditional rehab environment," says Binkley, who has become a tireless advocate for bringing attention to the physical and emotional side effects of breast cancer treatment. Her work has led her to speak locally, nationally and internationally and publish well-received papers about evidence-based physical therapy outcomes and breast cancer rehabilitation. Through TurningPoint, she has taken on an educational role for the healthcare community, as well as physical and occupational therapists who want to specialize in this specific area of rehabilitation. And her efforts – as well as those of TurningPoint's entire staff – are making a resounding difference.

SB-02"We have oncologists and surgeons in the Atlanta area that automatically refer their patients to us now," she says. In fact, TurningPoint sees 35 to 40 newly diagnosed patients per month from metro Atlanta and other outlying areas. "It's wonderful. It's so rewarding to be able to reach out and help other breast cancer survivors – to do this so other women won't have to search for what I was searching for," she adds.

Binkley also is thrilled that TurningPoint has become part of the research surrounding breast cancer rehabilitation. Recently, the organization partnered with Georgia Tech to help develop a way to identify lymphedema using three-dimensional photography and Xbox technology. The goal is to create a system for women to check at home on an ongoing basis so they can detect the condition early. Data will be collected through TurningPoint, which not only has the clinical experience necessary for such an endeavor, but also a state-of-the-art lymphedema measurement device that no one else in the region has in a clinical setting. It's the type of innovative, forward-looking effort that TurningPoint is perfect for.

"We named the organization TurningPoint because that's what our goal was – to be a turning point for breast cancer patients," Binkley states. "That's the most important thing for us. We want women who are going through breast cancer to know that we understand that there is so much going on physically and emotionally, and we can help. All women in the United States deserve this kind of care. That's my ultimate goal – to be part of a woman's standard of care."

Of course, there are challenges, including serving women who are going through something so familiar to the TurningPoint staff. "It brings back memories," Binkley says. "But at the end of the day, even if it feels sad or scary, we realize that if we're not here for them, who will be? And we get over it. We think about them. We put that ahead of everything else."

For Binkley, that message is crucial, especially being a two-time breast cancer survivor. She sees herself and her staff as role models for women who are newly diagnosed or in the middle of their own journeys. "We're here, and we're healthy. We want to give them the message that they can get through this," she concludes. "And we want to say to them, 'We're here for you. We'll walk by your side.'"

 

 

Thursday, 24 September 2015 13:36

Navigating Life After Breast Cancer

By Kathy Kantorski

In the spring of 1999, a woman was diagnosed with stage 3 breast cancer. Her annual mammogram six months prior didn't detect any tumors; in a matter of weeks, the tumor had formed, and the cancer had advanced to a near-fatal stage. She underwent a lumpectomy, chemotherapy and radiation treatments. Her usual cheerful demeanor became shadowed by a cloud of exhaustion. Her golden hair was gone, then replaced by patches of gray fuzz which she covered with scarves and wigs. She was too weak and nauseated to cook meals for her family, as she had done every day for nearly 20 years. But she remained strong. She chose to keep her job, working at least four hours every day throughout the treatments. She went to church every Sunday, socializing with friends and sharing her experience. And she survived.

That woman is my mom. I was 17 years old when she fought and survived breast cancer, an impressionable age that allowed the experience to be permanently burned into my memory. And in the years that followed, I watched my mom struggle to thrive again. The severe physical and emotional trauma of the cancer meant her fight didn't end when she overcame the disease; it simply evolved into a different struggle. Her treatments caused early menopause, she underwent reconstructive surgery and she battled anxiety and depression.

PHOTO-01My mom is not alone in her post-treatment struggles. One in eight US women will develop invasive breast cancer in her lifetime. You've likely heard of the causes, screenings and treatments, but not of the aftermath – until now.

Physical rehabilitation

The most common side effect from breast cancer treatment is fatigue. To combat this, experts recommend a moderate exercise program to increase energy levels, decrease depression and reduce pain. "Some studies show that regular exercise, such as walking 2.5 hours weekly, can actually lower the risk for cancer recurrence," says Dr. James Hamrick, the chief of medical oncology and hematology for Kaiser Permanente of Georgia.

Exercising the arms is recommended for women whose breast cancer treatment involved the removal of lymph nodes and radiation, as they are at risk of developing lymphedema, or swelling, in the affected arm. "Lymphedema may be mild and short-lived or become chronic. It may occur early after treatment or months or years later," explains Lisa Sherman, BSN RN, breast health nurse navigator at WellStar Kennestone Regional Medical Center. "Exercising the affected arm regularly to keep fluid from accumulating is important."

According to Jill Binkley, breast cancer survivor and executive director of TurningPoint Breast Cancer Rehabilitation, as many as 60 percent of breast cancer survivors face lingering issues years after their treatment that may prevent them from fully returning to their usual roles and activities, such as lifting their children, playing sports and work demands. She notes that initiating physical therapy, massage therapy and exercise within the first few weeks following surgery is ideal and can help women get back to a full life.

Self-esteem

"Breast surgery and the side effects from treatment – hair loss, nausea, fatigue, weight gain, hot flashes – can wreak havoc on a woman's self-esteem," says Dr. Jane Lowe Meisel, medical oncologist for the Winship Cancer Institute of Emory University. "In addition, many women are used to serving as a support system for their loved ones. Learning to accept help and support rather than giving it can be very challenging."

Meisel recommends seeking support outside of your network of family and friends, such as in a support group. "Hearing from others who are going through or have gone through the same thing can help normalize the experience," she says.

Cati Diamond Stone, breast cancer survivor and executive director of Susan G. Komen Greater Atlanta, agrees. "I have found it immensely important to get involved in the breast cancer community and support organizations that help and empower others," she says. She goes on to note that reconstructive procedures can also do wonders to increase self-esteem. "After months or even years of treatment, you finally have control over how you look, how your clothes fit – how you feel about yourself. It's such a personal decision, but for me, reconstructive surgery was an important part of my healing process."

Intimacy

"Breast cancer is a challenge to the intimacy of even the best relationships," Binkley notes. This can be a result of low self-esteem and insecurity regarding physical changes in the breast(s), as well as fatigue and early menopause caused by cancer treatments. "The medicines prescribed can lower estrogen levels, cause vaginal dryness and lower the libido," adds Dr. Stephen Szabo, section head of community oncology at Winship Cancer Institute.

Communication surrounding the problem is imperative. "Given that intimacy can be challenging enough without cancer, I advise patients and their partners to open up and talk to one another," Hamrick says. "They can also benefit from additional expertise from a therapist or their gynecologist."

The worry of recurrence

Though the healthcare industry is getting better and better at detecting cancers early and treating them, there is always a risk that the cancer will recur. Binkley says, "When breast cancer treatment is complete, women need to trust and hope that the cancer will not return. Living with this fear of recurrence is one of the biggest emotional challenges faced by breast cancer patients."

SB-01

This worry of recurrence will drive many women to "living test to test," as Hamrick puts it, meaning they need a scan or blood test with negative results to help them sleep at night. "Often, over-testing causes more problems and anxiety than it fixes," he says. "It's best to live a healthy, active life and be vigilant for new symptoms, but also learn not to panic with any new feeling. That's an understandably hard thing to do for a cancer survivor."

He goes on to explain that those who are years past their breast cancer treatment can often overestimate the threat breast cancer poses to their health relative to other risks. "Things like obesity, smoking and a sedentary lifestyle actually become larger causes of competing mortality. I like it when survivors are able to channel their motivation to beat breast cancer into healthier overall lifestyle choices."

Post-cancer treatments

Approximately 80 percent of women have estrogen-receptor-positive breast cancers, says Barbara Robey, LCSW, clinical social worker, counselor and coach for Chapman Cancer Wellness at Piedmont Healthcare. "In these patients, we recommend that they receive at least five years of either Tamoxifen or an aromatase inhibitor. These oral medications reduce the risk of cancer recurrence by 50 to 60 percent." The medication can have side effects like blood clots, cognitive impairment and menopausal symptoms, but Meisel adds, "There are a number of treatments we can use to help with these side effects, so it is important to mention these to your provider."

The silver lining

Eighty percent of women diagnosed with breast cancer do not die from their cancer, according to Dr. Laura Pearson, breast surgeon and medical director of the North Fulton breast program at North Atlanta Surgical Associates. "I like to use the analogy of cancer being like a flat tire, not a car accident," she says. "While it is something that cannot be ignored and you can't move forward until it's fixed, most likely you will get past it and continue your journey."

That being said, breast cancer survivors have the benefit of a newfound outlook on life. As Binkley puts it, "As a 15-year breast cancer survivor, there is not a day that goes by that I am not reminded in some way of my experience. But there is also not a day that goes by that I am not reminded of the blessing of having a husband, family and friends who have supported me every step of the way. Life is different, but can actually be better after breast cancer."


EDITORIAL RESOURCES

Jill Binkley, TurningPoint Breast Cancer Rehabilitation – www.myturningpoint.org
James Hamrick, MD, MPH, Kaiser Permanente of Georgia – www.kp.org
Jane Lowe Meisel, MD, Winship Cancer Institute of Emory University – www.winshipcancer.emory.edu
Laura Pearson, MD, North Atlanta Surgical Associates – www.nasasurgeryatl.com
Barbara Robey, LCSW, Chapman Cancer Wellness at Piedmont Healthcare – www.piedmont.org
Lisa Sherman, BSN RN, WellStar Health System – www.wellstar.org
Cati Diamond Stone, Susan G. Komen Greater Atlanta – www.komenatlanta.org
Stephen Szabo, MD, Winship Cancer Institute of Emory University – www.winshipcancer.emory.edu

Wednesday, 23 September 2015 20:40

Our Top 10 Picks for Workout Wear

By Amelia Pavlik

The perfect pair of comfy running shoes could carry you over the finish line at this year's fall 5Ks. Workout capris can make you feel fabulous whether you're at bootcamp or brunch. Whether it helps you perform better in that race or just makes you look good, having the right gear plays a role in your fitness success.

If you're looking for a workout wardrobe boost to help motivate you to move, read on for Best Self's top five picks for ladies and gents.

 

 

For Men

Photo-01Mizuno Venture Sleeveless
Available at: www.mizunorunning.com
Price: $39 Size: S-XXL

"This running tank uses Mizuno's COOLTOUCH and BLINDSTITCH construction," says Alyssa Jordan, business unit manager of running apparel and accessories of Atlanta-based Mizuno. "So it will keep you cool and dry and is designed for anti-chafing and a comfortable fit."

Photo-02Brooks PureGrit Trail Running Shoe
Available at: Big Peach Running Co., www.bigpeachrunningco.com
Price: $120 Sizes: 7-14

"This shoe fits like a glove without sacrificing protection. You will feel in control of every step on the ground beneath you," says Rachel Tucker, general manager of Big Peach's East Cobb location. "It has an outsole peppered with hex lugs for maximum grip, while a propulsion plate protects your foot from rocks and roots on the trail. Lastly, there is a toe guard to provide protection and added traction when the trail gets steep."

Photo-03Core Short
Available at: Lululemon, www.shop.lululemon.com
Price: $58 Sizes: S-XXL

These sweat-wicking shorts were made with multisport versatility in mind, says Helen McKeon, southeast area community strategist for Lululemon. "We added LYCRA fibre to the secure-fit waistband for great stretch and shape retention," McKeon says. "Plus, we've added an easy-access side pocket with a key loop for convenience."

Photo-04Mizuno Men's Helix
Seamless T-Shirt
Available at: West Stride, www.weststride.com
Price: $45 Sizes: S-XL

"This is a shirt that functions well and feels weightless," says Deeter Dietz, West Stride assistant manager. "It's seamless, the fabric is breathable and lightweight, and it just
looks good!"

Photo-05Freefly Bamboo Lightweight Long Sleeve Shirt
Available at: Half-Moon Outfitters, www.halfmoonoutfitters.com
Price: $49.95 Sizes: S-XL

For those days you need a little more coverage, try this shirt. The soft fabric provides UPF 15 sun protection, says Laura Elliott, a buyer for Half-Moon Outfitters. "The fabric wicks moisture and provides natural resistance to odor," Elliott explains. "The off-the-shoulder fit provides great range of motion. It's a wonderful option for any outdoor activity."

 

For Women

Photo-06Mizuno Serenity T-Shirt
Available at: www.mizunorunning.com
Price: $44 Sizes: XS-XL

According to Mizuno's Alyssa Jordan, this classic running T-shirt is perfect for an intense workout. "The front panel is made of our COOLTOUCH technology, which draws heat from the skin to keep you dry and cool," Jordan explains. Plus, she adds, "The front and mesh back panel offer flat seams to prevent chafing."

Photo-07Lively Capri by Lole
Available at: Big Peach Running Co., www.bigpeachrunningco.com
Price: $90 Sizes: XXS-XL

"This capri smooths and shapes like no other," says Big Peach's Rachel Tucker. "The quick-dry Supplex fabric offers four-way stretch and UPF 50+ sun protection. And the Power Mesh liner at the abdomen delivers firm core support for a smooth silhouette and a stay-put fit."

Photo-08Pace Rival Skirt IIR
Available at: Lululemon, www.shop.lululemon.com
Price: $58 Size: 2-12

"This skirt is designed to feel light and keep you covered when you hit the trails or the court," says Helen McKeon, southeast area community strategist for Lululemon. And it doesn't stop at comfort and style: it's functional, too. "Our signature three-pocket waistband has room for all of your essentials," McKeon says.

Photo-09Elomi Energise Sports Bra
Available at: Livi Rae Lingerie, www.liviraelingerie.com
Price: $70 Sizes: 36F-44F, 36G-44G, 36H-42H, and 34J-38J

"This sports bra is an absolute must for full-busted women since it provides maximum support for high impact activity," co-owners Molly Hopkins and Cynthia Decker say. "This style is a great multipurpose sports bra that offers a racer back option created by a J-hook feature built in to the straps."

Photo-10New Balance Fresh Foam Zante
Available at: West Stride, www.weststride.com
Price: $100 Size: 5-12 (wider widths available)

"This shoe is a lightweight trainer that is flexible, feels fast and has plenty of cushion for the long run," says West Stride general manager Wil Cramer. "The best part is that this shoe not only can help boost your performance –it's actually pretty stylish, too!"

 

Editorial Resources
Wil Cramer, West Stride, www.weststride.com
Cynthia Decker, Livi Rae Lingerie, www.liviraelingerie.com
Deeter Dietz, West Stride, www.weststride.com
Laura Elliott, Half-Moon Outfitters, www.halfmoonoutfitters.com
Alyssa Jordan, Mizuno Running, www.mizunorunning.com
Molly Hopkins, Livi Rae Lingerie, www.liviraelingerie.com
Helen McKeon, Lululemon, www.shop.lululemon.com
Stephanie Michael, Village Podiatry Centers, www.villagepodiatrycenters.com
Rachel Tucker, Big Peach Running Co., www.bigpeachrunningco.com

 

 

Wednesday, 23 September 2015 20:28

A Gentler Approach

As a child, Assia Stepanian, MD, knew that she would make a difference in the field of medicine. The daughter of two renowned physicians, the Moscow-raised founder of Atlanta-based Academia Women’s Health & Endoscopic Surgery has brought a wide variety of Minimally Invasive Gynecologic Surgery (MIGS) options to patients in metro Atlanta and devoted herself to sharing her specialized knowledge with physicians worldwide. An active member of the American Association of Gynecologic Laparoscopists (AAGL), she proudly follows in the footsteps of her mother, Dr. Leila Adamyan, who developed some of the most advanced techniques in the practice of MIGS. Here, Best Self Atlanta talks to Dr. Stepanian about MIGS, her commitment to providing compassionate care and how it can completely change the patient experience.

SB-01Q: What is Minimally Invasive Gynecologic Surgery (MIGS)?

A: Laparoscopic, robotic, vaginal and hysteroscopic surgery are all forms of Minimally Invasive Gynecologic Surgery. These are surgeries performed through small incisions or sometimes require no incision at all.

Q: Why has it been important for you to devote so much of your career and life to learn, teach and implement MIGS approaches?

A: A doctor’s sense of fulfillment in medicine comes from seeing our patients happy for many years to come. Minimal intervention, combined with early recognition and successful treatment of the disease are, in my opinion, the keys of our patients’ long-term health. With early recognition of and attention to gynecologic diseases and the risks in their development, the least degree of the intervention will be required. The more we know about minimally invasive approaches in treatment, the more open will we be as physicians to intervene earlier. It is hard for physicians and patients to believe that minimally invasive surgeries can be offered even to patients with very advanced states of gynecologic conditions.

Q: What kinds of conditions can be treated with MIGS approaches?

A: It is impressive that essentially all gynecologic conditions that require surgery can be treated with one or more MIGS approaches, including uterine fibroids of sometimes very large sizes, pelvic pain, endometriosis, pelvic floor surgery (including cases in which the uterus descends completely outside of the vaginal canal), urinary incontinence, ovarian masses and adhesions (scar tissue), among other conditions. In addition, multiple forms of genital anomalies can be treated laparoscopically and hysteroscopically.

Q: What are the main benefits of MIGS?

A: Laparoscopy, whether or not it is performed robotically or with laparoscopic instruments, allows for superior visualization of the targeted tissue in surgery and outstanding performance of the surgery through small incisions.

Therefore, the precision of surgery increases and tissue handling becomes more intricate and gentle, with less tissue manipulation and less blood loss. In most surgeries the blood loss is of 25 – 50 ml, which is less than experienced during menstruation. The result includes decreased risk of perioperative infection and an early return to normal activities both in life and work as compares with open surgery. Some people return to work in only one or two weeks after surgery, even if the surgery is performed for an advanced disease. Additionally, there is hardly any use of narcotic medications post-operatively. Motrin is used as the primary medication for pain. Patients who receive the vaginal approach to surgery, which is the oldest of all minimally invasive approaches, have no abdominal incisions whatsoever and experience the same excellent recovery rates as laparoscopy. It is used when evaluation of the abdomen and upper aspect of the pelvis is not required. And hysteroscopy…what can I say? Hysteroscopy became our inspectional and operative window into the woman’s uterus. It allows for early intervention in the office setting or surgical suites and often prevents the need for more invasive uterine surgery.

Q: Have you had formal training in MIGS?

A: The American Association of Gynecologic Laparoscopicsts (AAGL) has a very strong fellowship in MIGS and offers formalized training. I have completed my formal fellowship with Dr. Thomas Lyons, an exceptional surgeon and visionary who founded one of the first Minimally Invasive Fellowships in AAGL. My initial training and continuous training in laparoscopy, hysteroscopy and vaginal surgery was performed by my mother, Professor Leila Adamyan, the author of surgical techniques, classifications, books, who has taught many beautiful surgeons in Russia and in various countries. She is my primary mentor in life and surgery, and through her I have met and learned from our many good friends and superb surgeons worldwide. 

Photo-1Q: Your practice has been certified as a Center of Excellence in Minimally Invasive Gynecology Surgery. What does this mean?

A: The concept of a Center of Excellence in MIGS has been established in an effort to encourage development in MIS approaches in gynecology. We are hoping that with the opening of more Centers of Excellence, there will be more commitment to minimally invasive surgery.

Q: Your practice is also known for offering truly compassionate care. Why is this important to you?

A: It defines the entire purpose of my work. I am in the medical field because of my love for patients. I treat my patients as my family—with love, expectation, understanding, attention and compassion. I hope to always be able to empower and remind them that the world is beautiful and that whatever goes on with their heath is just a small hiccup in their life journey. I am truly blessed by my patients, and I am thankful to them for their trust, love and support.

Q: Can patients come to your practice even if you are not their current physician?

A: Yes, we are always accepting new patients and we are also very fortunate to receive referrals from many wonderful physicians. We evaluate those patients and establish a care plan. I always communicate with the referring physicians about any questions in order to make sure that the best strategies are selected and the risks are minimized for patients. If we select non-surgical approaches, we agree on parameters, after which additional intervention may need to be considered.

Q: What do you see for the future of MIGS and women’s healthcare?

A: MIGS will continue to develop in its applications and advancements. Performance of MIGS involves advanced training, and I would like to see more gynecologists obtain formal training in minimally invasive approaches to surgery. I also see us collaborating with other specialties, engaging integrative approaches in studying and treating a disease. Unification of the world of MIGS will be yet another advancement: we need patients, doctors, nurses, hospitals, insurance companies and manufacturers to combine their knowledge and abilities to serve the needs of the patients.

Q: Is there any place for an open surgery in benign gynecology, then?

A: Absolutely, there is! There are very rare times when MIGS is contraindicated or would not be the method of choice. A consultation with a specialist in MIGS would be able to address this most effectively.

Thursday, 10 September 2015 20:50

iShapify

Thursday, 10 September 2015 20:25

Clear Path Wellness

Wednesday, 09 September 2015 15:19

Body Symmetry MD

Wednesday, 09 September 2015 14:40

Anderson Hair Sciences Center